Early and extensive experience with middle ear infections (chronic otitis media, COM) has been linked to a number of negative developmental outcomes in young children including mild to moderate hearing losses, and problems with attention, behavior, language development and speech development. Studies specifically focusing on the nature of speech development with COM have been less abundant and results remain confusing and contradictory. The purpose of the proposed research is to describe the nature of early speech development in children with COM and its relationship to caregiver interactions. It is hypothesized that one of the earliest warning signs of negative outcomes is the emergence of atypical speech patterns as toddlers move from babbling to meaningful speech production. It is further hypothesized that unintelligible speech is a precursor of problematic verbal interactions with caregivers and limits a child's opportunities to practice newly learned speech sounds and develop an adult-like sound system. Two related studies are proposed. In Study 1, the speech development of 60 children who entered daycare as infants (approximately 6 months of age) will be measured longitudinally at ages 12, 18, 24, 30, and 36 months of age. Quantitative measures of speech production and intelligibility in those children with COM will be compared to those of otitis-free children to determine if early speech status mediates later verbal interactions. In Study 2, speech samples of a subset of 20 children, 10 with COM and 10 otitis-free, will be measured repeatedly (every two weeks) from the babbling period through the establishment of systematic sound correspondences with the adult phonology (about 30 months). Samples will be analyzed both perceptually and acoustically to reveal any subtle differences that characterize changes in speech production during episodes of OM. Results will assist in identifying the limits of individual variation and determining the positive or negative effects of following alternative compensatory routes in phonological acquisition. Findings from this project will provide empirical support for building new models of the sequelae of otitis media, identifying children at risk for speech delays or disorders, and the design of projects focusing on early communication intervention.